The modern era of state restrictions on abortion began in 1992 with the Supreme Court's decision in Planned Parenthood v. Casey. The court upheld Roe v. Wade but said states have a right to regulate abortion as long as they don't write laws that impose an "undue burden" on women. Pro-life politicians enacting laws to limit abortion are now testing the limits of the Casey ruling. Their ultimate goal is to land another abortion case before a sympathetic Supreme Court in an attempt to overturn Roe. Along the way, in what Charmaine Yoest, president of the antiabortion group Americans United for Life, describes as a strategy to "work around Roe," pro-life activists hope to severely--or completely--curtail access to abortion at the state level.

In Mississippi, pro-life activists pushed for passage of a 2012 law requiring that doctors who perform abortions have admitting privileges at local hospitals. None of the out-of-state physicians who perform abortions at the state's sole abortion clinic have these privileges. The clinic remains open while a federal judge examines the constitutionality of the law and whether it presents an undue burden to women seeking abortions. Governor Phil Bryant, who signed the law, said it was part of an effort to "end abortion in Mississippi."

The Volunteer Women's Medical Clinic in Knoxville, Tenn., was open for 38 years before it closed in August 2012, citing the state's Life Defense Act, passed earlier in the year, which also requires doctors to have hospital admitting privileges. A doctor who worked at the facility obtained hospital privileges but died suddenly of a stroke, and clinic director Deb Walsh said she couldn't afford to keep her doors open while she tried to replace him.

In Virginia, the state board of health adopted a rule last year requiring abortion clinics to comply with architectural zoning regulations for hospitals. Like the Mississippi law and one just enacted in Michigan requiring abortion clinics to be licensed, the Virginia rule seems designed to make clinics safer, but there is little evidence that women's health had previously been in danger. Loretta Ross, who co-founded Sister Song, an Atlanta-based reproductive-rights group focused on the needs of women of color, is among those in the pro-choice movement who marvel at the pro-life strategic vision even though she opposes its goals. "The entire women's-health movement was predicated on the lack of women's safety and gender consciousness in health care settings," says Ross. "It is a classic example of our opponents learning from us and taking our script."

In fact, those most affected by new zoning laws are independent clinics like Red River, whose tight margins make it financially burdensome for them to adapt to new requirements. Planned Parenthood is the largest abortion provider in the U.S., but independent clinics collectively deliver the majority of abortions in America. And as abortion services have become concentrated in specialized clinics--as opposed to hospitals, which accounted for the vast majority of abortion facilities in 1973--clinics have become easier targets. Pro-life groups celebrate every clinic closure.